Wiki Billing 97112 for CVA patients

AmyReed

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I do billing for a physical therapy office in MS. They want to charge 97112 for a patient that suffered a CVA. Unfortunately, none of the dx codes for CVA/late affect of CVA are showing as medically necessary on the MS LCDs. This doesn't make much sense to me given the definition of procedure coe 97112. Any suggestions?
 
I haven't looked at the LCD for that code, but does the pt have any dx such as abnormality of gait, hemiparesis, etc, due to the CVA?
 
first you must use the V57.1 as the first listed dx code, look in the official ICD-9 CM guidelines page 12 #15 for this information, then secondary you use the reason for the rehab, which should be a 438.x code for late effect of CVA.
 
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